Quality measurement is a key component of health care delivery and payment reforms, and many states are working to align quality measures across payers. Both public and private payers develop quality measure sets to track performance and target quality improvement efforts. However, these measure sets often have varying reporting requirements and may be collected on different timelines. These differences can create increased administrative burdens on providers, which in turn can make it difficult for providers to focus time on care delivery transformation.
This recently released paper describes the efforts of several states pursuing quality measure alignment across payers. It includes a framework for states to consider as they pursue their own alignment efforts, as well as a comparison table of state approaches to this work. The table highlights the following components of state alignment efforts:
- Impetus for alignment (e.g., whether the efforts were required by law or part of a voluntary transformation effort),
- Goals of alignment (e.g., public reporting, reducing costs, achieving the triple aim),
- Criteria for selecting aligned measures
- Stakeholder involvement
- How measures will be used and by whom
- How frequently the measures will be updated
The paper also includes a tool for states to catalogue existing quality measures and identify current alignment, and to consider how those measures meet states’ goals and evaluation criteria.
This paper was produced by SHADAC with support from the Center for Medicare & Medicaid Innovation (the Innovation Center). SHADAC is part of a team led by NORC at the University of Chicago that serves as the State Innovation Models (SIM) Resource Support Contractor. SHADAC and other technical assistance partners support states and the Innovation Center in designing and testing multi-payer health system transformation approaches.